Infected large pore meshes may be salvaged by topical negative pressure therapy

Hernia. 2013 Feb;17(1):67-73. doi: 10.1007/s10029-012-0969-3. Epub 2012 Jul 27.

Abstract

Purpose: To evaluate the efficacy of negative pressure therapy for superficial and deep mesh infections after ventral and incisional hernia repair by a prospective monocentric observational study.

Methods: During a 6-year period, 724 consecutive open ventral and incisional hernia repairs were performed. Pre- and intraoperative data as well as postoperative complications were prospectively recorded. In case of wound infection, negative pressure therapy (NPT) was our primary treatment.

Results: Sixty-three patients (8.7 %) were treated using negative pressure therapy after primary ventral and incisional hernia repair. Infectious complications needing NPT occurred in 54 patients in the retromuscular group (54/523; 10.3 %), none when laparoscopically treated and in 9 patients (9/143; 6.3 %) treated by an open intraperitoneal mesh technique. Considering outcome, all meshes were completely salvaged in the retromuscular mesh group after a median of 5 dressing changes (range, 2-9), while in the intraperitoneal mesh, group 3 meshes needed complete (n = 2) or partial (n = 1) excision. Mean duration to complete wound closure was 44 days (range, 26-63 days).

Conclusion: NPT is a useful adjunct for salvage of deep infected meshes, particularly when large pore monofilament mesh is used.

MeSH terms

  • Adult
  • Aged
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / adverse effects*
  • Herniorrhaphy / methods
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy*
  • Prospective Studies
  • Recurrence
  • Seroma / etiology
  • Surgical Mesh / adverse effects*
  • Surgical Mesh / microbiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / therapy*
  • Time Factors
  • Young Adult